TEN YEARS OF EXPERIENCE IN MANAGING PATIENTS WITH BURN CONTRACTURES OF AXILLA, ELBOW, WRIST, AND KNEE JOINTS

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Abstract
Hypertrophy and contracture of scars are common sequelae seen in patients with severe burns. These changes may impair the movement of various joints. The surgical restoration of deformed joints can be difficult. Although the use of splints and continuous pressure across these joints has been effective in minimizing these problems,1,2 the true efficacy of this regimen in preventing joint dysfunction remains undefined. After we had noticed that the faithful use of splints in patients with neck burns decreased the incidence of neck contracture from 37 percent to 9 percent,3 we reviewed the records of 830 patients treated at our hospitals during a 10-year period to evaluate the efficacy of splints and pressure upon burn scars across the major body joints. An analysis of 625 patients who had sustained burns across the axillae, elbows, wrists, or knee joints indicates that the use of splints and pressure across these joints will not only greatly decrease the incidence of contractures but will also reduce the frequency and need for release operations. However, these appliances must be used for at least 6 months (longer, if possible), if substantial benefits are to be obtained.

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